Chapter 229 A difficult separation, a heart-warming moment

Surgical skills are really just one step at a time.

Each level has different abilities.

It is an entry-level incision method that is scary to use once. In fact, you would not dare to use it on patients unless you are extremely brave and do not take human life seriously.

Skilled-level incisions can be stronger and can make incisions in non-vital parts such as limbs, but the resulting wounds will be uneven and the edges of the wounds will be difficult to describe.

Sometimes if it is not done well, it is easy to make a wavy wound.

Because the dissection is performed layer by layer, if the incision is not made properly when cutting the first layer, it will definitely affect the subsequent incisions.

Moreover, debridement is required before suturing.

Otherwise, the patient's wound may heal very poorly.

"Not bad, not bad, the cut is really beautiful! I don't have to mention the bleeding control. Don't be stunned while retracting the hook, and get to work quickly."

Director Hua was very satisfied with Li Jingsheng's performance.

The second and third assistants had cleverly used flat hooks to open the opening, exposing the spinous processes of the lumbar vertebrae.

At this time, you can see that there are many muscle groups on both sides of the spinous process.

Including spinalis dorsi, multifidus, interspinalis, etc.

Therefore, it makes sense that everyone likes to eat tenderloin when buying pork. This part is rich in lean meat and the meat quality is also very good.

"Jingsheng, the myofascia needs to be incised along both sides of the spinous process. The venous plexus below is extremely rich, so be careful."

Director Hua still asked Li Jingsheng to continue the operation.

"OK!"

Li Jingsheng was secretly glad that he had just upgraded the incision method to Dacheng, otherwise it would be easy to miss when facing the rich venous plexus.

It is difficult to stop bleeding in this area, and it will be troublesome to cut the blood vessels.

Now, he was exactly like a experienced deputy chief physician, incising the myofascia next to the spinous process bit by bit.

The whole process is done with great care.

During the separation, his scalpel is always close to the bone surface and performs subperiosteal dissection.

When all is completed, the patient's vertebrae can be clearly seen.

He couldn't help but sweat breaking out on his forehead.

Although the traveling nurse was a bit fierce, her eyes were sharp and she took the initiative to help him wipe away his sweat.

No need to even say hello.

He felt that his separation skills seemed to have improved a lot.

I took the time to look at the properties.

Proficient in sharp traditional scalpel separation method 375/500.

The speed at which this proficiency increases is simply terrifying.

It feels like one stabbing blow has at least added five points of proficiency to him.

However, the tension of walking on thin ice, as well as the feeling of using incision and dissection together and fusing them together, gave Li Jingsheng a new understanding of these two surgical skills.

He took a look at his health value and was also surprised that it had increased by more than two hundred.

Two hundred of them will definitely be prizes.

The operation is still continuing.

The next task will be more difficult, requiring separation of the muscles next to the spinous process.

It is more difficult than incising myofascia.

Moreover, because this patient had undergone surgery and had a tough tendon attachment, it was even more difficult.

"Bone Knife!"

When Li Jingsheng saw that Director Hua didn't stop him, he was ready to challenge again.

In fact, with the adult-level incision method, there is no problem in cutting this area. However, the sharp separation method is a bit behind, and the proficiency level is still a bit weak.

It's okay to deal with ordinary surgical separation tasks, but it's quite risky to deal with such difficult tasks.

He very carefully used a bone knife to cut open bit by bit and peel off the spinous processes one by one.

As soon as the knife was cut, blood came out.

"Did I get into trouble?"

Li Jingsheng looked up at Director Hua with a guilty conscience.

When we separated just now, we could clearly feel that the attached tendons were very tough. If we applied just a little force, we couldn't separate them at all.

So I increased my strength.

The result is the current situation.

He could feel the blood vessels being broken through the knife feedback from the bone knife.

"Don't panic, no matter who else does the operation, this will be the result. You have almost no experience in this area, so some bleeding is normal."

Director Hua comforted Li Jingsheng and personally stepped forward to help Simple stop the bleeding.

"Continue! Once you've peeled it all off, you can then use gauze to pack it to stop the bleeding."

Li Jingsheng was relieved by Director Hua and immediately operated on the patient again.

My mood was somewhat affected.

However, his progress is also very obvious.

In order to avoid getting into trouble again, he quietly upgraded the sharp separation method from mastery to master level.

After spending more than 700 life points, the life points that were finally accumulated were used up and only more than 200 were left.

His health balance rarely seems to exceed one thousand for a long period of time.

It will be used every time.

I have to admit that after the sharp separation method was improved, the entire peeling process was obviously much smoother.

For some parts that are difficult to peel off, he can feel much more relaxed when operating.

The control of strength, depth, and handiness have all been greatly improved.

After all five spinous processes were peeled off, he breathed a sigh of relief.

I have never experienced such a difficult surgical procedure.

Fortunately, my life was fulfilled. Except for breaking the blood vessel when the tough tendon attachment was separated, the subsequent bleeding was very small.

"Jingsheng, thank you for your hard work! You performed very well. Especially after the patient's spinous process and the blood vessel between the lamina suffered a large bleeding, you were able to quickly stay calm from the panic and complete the subsequent surgical tasks calmly. This is very good. I believe it."

It is also a very good training and improvement for your character."

Director Hua spoke highly of his surgical performance.

When a young doctor goes to the operating table, lack of technical proficiency is only one aspect. Mental training is also very important.

Don't panic when something happens, you need to deal with it calmly.

"Now you carefully watch my steps to stop bleeding. Use gauze to fill the space between the muscles and bones. Be sure to pack it tightly, otherwise the hemostatic effect will not be achieved at all."

As Director Hua packed the gauze in, the bleeding stopped quickly.

This principle is actually to apply pressure to stop bleeding.

Li Jingsheng has mastered compression and hemostasis, but his level is not yet high.

Standing by and studying at this moment has gained a lot.

"Director Hu, come and bite off the spinous process!"

For some surgical procedures that are too high-risk and difficult for novice doctors to master, Director Hua will not easily let his doctors take risks.

Because some surgical steps have the opportunity for trial and error, and some do not.

As long as it is damaged, it will immediately become a surgical accident and there is no room for recovery.

Li Jingsheng was also asked to study the laminectomy after removing the spinous process, and gave some detailed guidance and explanations.

Those who can participate in this operation are all excellent orthopedic surgeons.

It can be regarded as integrating the cutting-edge power of orthopedic surgery.

However, it is only limited to the two levels of deputy director and attending.

As for the resident doctors, only Li Jingsheng has this honor among the residents.

Other senior residents can only observe and learn under the operating table.

…
To be continued...